Urinary Incontinence

WHAT YOU SHOULD KNOW:

Urinary incontinence (UI) occurs when you leak urine. Your bladder is an organ that stores urine until it leaves your body through your urethra. There are muscles around your urethra, called sphincter muscles, that keep your urethra closed. Normally, when your bladder is full the bladder muscle contracts (tightens), and the sphincter muscles relax and open. Once the sphincter muscles open, the urine can flow through your urethra and out of your body. With UI, you are not able to control when urine leaves your bladder. The most common types of UI are stress UI, urge UI, and mixed UI. With stress UI, you leak small amounts of urine with activities, such as exercising, sneezing, coughing, or lifting. With urge UI, you may feel the need to urinate right away, causing small or large urine leaks. You have mixed UI when you have both stress and urge UI.

UI may occur if you have weak bladder, pelvic, or sphincter muscles. You may have UI if your bladder has trouble storing and emptying urine, or if your bladder contracts too often. Your risk for UI increases if you are a female who has given birth, or you are elderly. Your risk also increases if you are overweight, take certain medicines, have had pelvic surgery or a spinal cord injury. Urine tests, a cough stress test, and tests to check the pressure in your bladder may diagnose your UI. Treatment may include medicines, exercises, or surgery to help support your bladder and improve bladder control. Treatment may decrease, or stop, urine leaks, and help you control when you urinate.

AFTER YOU LEAVE:

Medicines:

Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.

Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.

Anticholinergic medicine: Anticholinergic medicine may be given to decrease how often your bladder contracts and causes you to leak urine.

Hormone therapy: Women who have reached menopause may need to take the hormone estrogen. Menopause occurs when a woman no longer has a monthly period. Estrogen may help improve bladder control.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Ways to help improve your bladder control:

Ask your caregiver for more information about the following:

Biofeedback: Biofeedback is a special way to help you control how your body reacts. Biofeedback uses pictures and words to help you learn to control your pelvic floor muscles. Biofeedback may help you learn how to strengthen your pelvic floor muscles and decrease urine leakage.

Bladder training: The goal of bladder training is to help improve your bladder control. Bladder training includes urinating at certain times and doing pelvic floor muscle exercises. You may also learn to use relaxation and distraction to take your mind off the need to urinate. This may help decrease the urge to urinate, while increasing the amount of urine your bladder can hold.

Devices: Devices may be used to support your urethra and bladder to stop urine leakage. For men, a penile clamp may be used. For women, a vaginal cone, pessary, or tampon may be placed into the vagina to stop urine leaks. A vaginal cone is a small weight put inside the vagina. A pessary is a plastic or rubber ring. Tampons may be used to help stop urine from leaking during exercise.

Electrical stimulation: During electrical stimulation, electrodes send a small amount of electrical energy to your pelvic floor muscles. The electrical energy tightens your pelvic floor muscles to make the area stronger. Electrical stimulation treatment may be used with biofeedback to decrease urine leakage.

Pelvic floor muscle exercises: Pelvic floor muscle exercises help strengthen your pelvic muscles. The exercises may help to bring back or improve your bladder control. These exercises are done by tightening and relaxing your pelvic muscles. Ask your caregiver how to do pelvic floor muscle exercises, and how often to do them.

Self-catheterization: You may need to do self-catheterization if you do not empty your bladder completely when you urinate. You will insert a catheter (thin, bendable tube) into your bladder to drain any remaining urine. Caregivers will teach you how to put the catheter in safely. Emptying your bladder helps decrease how often you have the urge to urinate causing you to leak urine.

Limit the amount of liquid you drink:

You may need to limit the amount of liquid you drink each day to help decrease urine leakage. Limit or avoid drinks with caffeine and alcohol to help prevent increased bladder contractions. Caffeine may be found in coffee, tea, and some soft drinks. Alcohol is found in beer, wine, whiskey, and other adult drinks. Try not to drink liquids before going to bed to prevent having to urinate during the night. Ask your caregiver how much liquid you should drink each day.

Maintain a healthy lifestyle:

Exercising and maintaining a healthy weight may help improve your bladder control. Weighing more than your caregiver suggests makes you more likely to leak urine. Talk with your caregiver about a weight-loss plan if you are overweight. If you smoke, it is never too late to quit. Smoking harms your body in many ways. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. Ask your caregiver how to stop smoking if you are having trouble quitting.

Take care of your skin:

Leaking urine may make your skin red and sore. Wearing a pad can help absorb leaking urine and keep urine off your skin. Using wipes to clean your skin may help prevent odor, and help protect your skin.

Treat your constipation:

If you are constipated, you may have a hard time having a bowel movement (BM). Do not try to push the BM out if it is too hard. Walking is the best way to get your bowels moving. Eat foods high in fiber to make it easier to have a BM. Good examples are high-fiber cereals, beans, vegetables, and whole grain breads. Prune juice may help soften the BM. Caregivers may give you fiber medicine or a stool softener to help make your BMs softer and more regular. You can also buy these medicines at grocery or drug stores.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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